Sheeringa, M.S., Zeanah, C.H. (1994). PTSD Semi-Structured Interview and Observation Record for Infants and Young Children. Department of Psychiatry and Neurology, Tulane University Health Sciences Center, New Orleans.

Obtain(Email/Website):

mscheer@tulane.edu

Cost:

Free

Copyrighted:

No

Measure Description:

Semi-structured caregiver report measure used to assess PTSD in children 0-7 years of age. The measure assesses whether the child has experienced 11 specific traumas or an alternative trauma; and collects data regarding the first occurrence, last occurrence, and the number of times the event occurred. It includes questions for caregivers and collection of information for observation of the child during the interview.

It also includes a section for measuring functional impairment and distress, which are additional components needed for making a diagnosis. The interview provides diagnostic information based on the DSM-IV.

This interview has been used in a series of studies that have proposed and validated a set of diagnostic criteria that is a developmentally sensitive alternative to the DSM-IV. Clinicians who are interested in the DC: 0-3 definition of PTSD may find this measure useful because the DC: 0-3 criteria were based on this work. A diagnosis can also be made using the empirically validated alternative algorithm for young children.

Domain(s) Assessed :

Trauma Exposure/Reminders

Language(s) :

English

German

Hebrew

Spanish

Age Range:

0-7

Measure Type:

In-depth Assessment

# of Items:

29

Measure Format:

Semi-structured Interview

Average Time to Complete (min):

45

Reporter Type:

Parent/Caregiver

Average Time to Score (min):

1

Periodicity:

None reported.

Response Format:

Mixed response format: 0=No, 1=Sometimes, 2=Yes

Caregiver is asked the onset, duration, and frequency of the symptoms endorsed. Clinician also observes interaction of parentchild.

Materials Needed:

Paper/Pencil

Other Materials Needed:

Video equipment (optional)

Sample Item(s):

Domains

Scale

Sample Items

PTSD-RelatedSymptomatology(child)

Re-experiencing

Has your child made repeated statements or questionsabout the event? Did he appear distressed by these?

Avoidance

Since the event has your child tried to avoid places orpersons or things connected to the event?

Hyperarousal

Since the trauma has your child had a hard time goingto bed or falling asleep?

Alternate criteria

Did your child lose some skills he had learned before?Did he lose toileting skills, become mute, or lose somespeech skills?

Information Provided:

Areas of Concern/Risks

Clinician Friendly Output

Continuous Assessment

Diagnostic Info DSM IV

Dichotomous Assessment

Raw Scores

Other

Training

Administration Training:

> Or = to 4 Hours Training by Experienced Clinician

Training to Interpret:

Training by Experienced Clinician (4+hours)

Parallel/Alternate Forms

Parallel Form:

No

Alternate Form:

No

Different Age Forms:

No

Altered Version Forms:

No

Psychometrics

Clinical Cutoffs:

Yes

If Yes, Specify Cutoffs:

A clinician-friendly scoring algorithm is provided to help diagnose PTSD using either the alternative algorithm or the DSM-IV algorithm.

Reliability:

Type:

Rating

Statistics

Min

Max

Avg

Test-Retest

Not reported

Internal Consistency

Not reported

Inter-rater

Kappa

0.29

1

References for Reliability:

The range of kappas from .29 to 1.0 were for individual PTSD items in the Scheeringa et al. (2001) study. The median kappa was .74. The average was not reported.

In a second study, the kappa for all PTSD items was 0.75. The kappa for the full diagnosis was 0.74 in Scheeringa et al. (2001) and 0.79 in Scheeringa et al. (2003).

References for Content Validity:

Panel of experts in the field of infant and young child mental health reviewed the items.

Construct Validity:

Validity Type

Not known

Not found

Nonclincal Samples

Clinical Samples

Diverse Samples

Convergent/Concurrent

Yes

Yes

Discriminant

Yes

Yes

Sensitive to Change

Yes

Intervention Effects

Yes

Yes

Longitudinal/Maturation Effects

Yes

Sensitive to Theoretically Distinct Groups

Yes

Factorial Validity

Yes

References for Construct Validity:

Children who reached PTSD diagnosable criteria on the PTSD semi-structured interview scored higher on CBCL Internalizing and Total scores compared to healthy controls (Sheeringa, Zeanah, Myers, & Putnam, 2003). No children in a control sample of children met criteria for PTSD based on the measure as compared to 3 of the children in the traumatized sample (Sheeringa, Peebles, Cook & Zeanah, 2001).

Children diagnosed with PTSD at Time 1, exhibited greater symptomatology than those not diagnosed 1 and 2 years later, providing evidence for thepredictive validity of the measure. In addition, PTSD diagnosis at Time 1, predicted diagnosis 2 years later (Scheeringa, Zeanah, Myers, & Putnam, 2005). Children with higher levels of PTSD symptoms and less positive discipline from caregivers showed decreased heart period (increased heart rate) and decreased parasympathetic activity in response to a trauma stimulus (Scheeringa, Zeanah, Myers, & Putnam, 2004).

1. The control sample of children in the Sheeringa et al. (2001) study included males only.

2. Data are not provided regarding test-retest validity or internal consistency. The psychometrics have been primarily examined by the first author and his colleagues. More research is needed.

Translation Quality

Language(s) Other Than English:

Language:

Translated

Back Translated

Reliable

Good Psychometrics

Similar Factor Structure

Norms Available

Measure Developed for this Group

1. Hebrew

Yes

2. German

Yes

3. Spanish

Yes

Yes

Population Information

Population Used For Measure Development:

The measure was developed with a sample of 20 children identified through a literature search of previously published studies. Inclusion criteria included that the “infants had experienced a traumatic event (or series of events) before the age of 48 months and had been evaluated before the age of 48 months, and there were clinical data about individual cases.” Sufficient data either published in the article or provided by the author were alsorequired.

A second sample of 12 cases came from a university-based outpatient child psychiatry clinic (n=9) and infant intervention program in a shelter for homeless adolescents (Scheeringa, Zeanah, Drell, & Larrieu, 1995). The interview went through modified versions based on a study of 15 clinic patients (Scheeringa, Peebles, Cook, & Zeanah, 2001) and 62 non-clinic subjects (Scheeringa, Zeanah, Myers, & Putnam, 2003).

Measure has demonstrated evidence of reliability and validity in which populations?:

Physical Abuse

Medical Trauma

Domestic Violence

Accidents

Use with Diverse Populations:

Population Type:

Measure Used with Members of this Group

Members of this Group Studied in Peer-Reviewed Journals

Reliable

Good Psychometrics

Norms Available

Measure Developed for this Group

1.Lower socio-economic status

Yes

Pros & Cons/References

Pros:

1. Most thorough PTSD assessment for children under 6 years of age. Includes both parent report and direct observation of the child.

2. Measure developed specifically for young children and includes symptoms relevant to young children.

1. Requires strong clinical skills and understanding of child development to administer the measure.

2. It is relatively long to administer. However, the amount of time is appropriate, given the importance of this measure and the need to assess these constructs in an accurate and valid way.

3. Psychometrics have been examined only by authors, and with relatively small samples of children.

4. There is no coding of frequency or duration, which limits the ability to use these fields for data analysis and, like other similar diagnostic measures (e.g., DISC, SCID), there is no measure of intensity.

References:

A PsychInfo literature search (6/05) of “Posttraumatic Stress Disorder Semi-Structured Interview and Observational Record” or “PTSDSSI” anywhere and contact with the author revealed that the measure has been referenced in 8 peer-reviewed journal articles.